Monday, January 30, 2023
HomeHealthGUEST VIEW: Partnership in well being care alongside the Rio Grande/Bravo

GUEST VIEW: Partnership in well being care alongside the Rio Grande/Bravo

The fourth 12 months of medical college is meant to be the final hoorah earlier than dedicating the following 3-7 years doing a deep-dive of your chosen specialty, and so once I was invited to take a spontaneous street journey to the US-Mexico border to take part in rural neighborhood engagement, I needed to say “Sure”. The plan was to journey to Candelaria, TX, a predominantly Spanish-speaking neighborhood of about 75 inhabitants, to take part in a well being discussion board offering preventative well being screenings and affected person training. Driving alongside the Rio Grande with breath-taking views of the Chinati Mountains to the east and the northernmost stretch of the Sierra Madre Oriental to the west, it was sobering to consider the limitations to care these rural populations should overcome to entry medical consideration.

Once we arrived on the re-purposed “former” schoolhouse the place the well being discussion board was being held in Candelaria, we had been warmly obtained by Texas Division of Well being and Human Companies (TDSHS) employees (from El Paso, Presidio, and Austin) adorning Santa hats and reindeer antlers. Quickly thereafter, the schoolhouse was buzzing with kids able to study preventative oral hygiene and adults fascinated with measuring their blood pressures and glucose ranges. This comparatively small occasion required collaboration between a number of ranges of presidency organizations in addition to the assist of well being professionals (a dentist, a dental hygienist, a medical assistant, a medical scholar, two resident physicians and a college doctor) from varied fields. To see neighborhood well being at work and expertise first-hand how bodily remoted this tiny pueblo was from any main hospital was a useful lesson within the necessity of rural well being engagement. It doesn’t require a stretch of the creativeness to think about the problems a resident of Candelaria would face in the event that they wanted emergent workup for attainable stroke or intubation after a traumatic accident.

As a medical scholar, we’re preoccupied with processing the mountain of foundational scientific data essential to construct our expertise upon in residency, and so it may be simple to neglect that healthcare and the medical occupation encompasses a lot greater than the examination room or the surgical suite. Generally, medication takes you a number of hundred miles downstream of the Rio Grande to a quiet neighborhood nestled within the foothills of the Sierra Madre.

— Dalynn “Andy” Kim, MS-IV

TTUHSC Permian Basin

As a brand new full time educational doctor throughout the Rural and Group Engagement Division on the TTUHSC Permian Basin campus, I used to be delighted to take Andy and our two Alpine based mostly rural Household Drugs resident physicians, Cristina Rivera MD and Alex Bustamante MD, to the well being truthful in Candelaria, TX. Previous to August, I practiced full time within the Large Bend space residing in Alpine however touring to outlying federally certified well being clinics in Marfa and Presidio twice weekly. For many of my 16+ years of follow within the Large Bend, I’ve hosted each medical college students and resident physicians in our clinics and significant entry hospital in Alpine as a result of I take pleasure in exposing trainees to each the thrill and challenges of training full spectrum household medication in an under-resourced rural atmosphere. I really feel that these rural experiences are essential for future physicians to grasp the challenges that rural sufferers have in accessing care regionally in addition to the challenges that rural physicians have in offering care in these environments. In truth, the literature exhibits that any rural publicity in coaching for a resident doctor is strongly correlated with future rural follow.

My spouse and a couple of youngest sons had been delighted to satisfy Andy and her husband for dinner at a neighborhood Thai restaurant in Alpine the night earlier than we left for Candelaria. I wished to make use of the meal to satisfy her and her husband for the primary time, I wished my household to satisfy them and I wished to debrief in regards to the 300-mile journey from Alpine to Marfa to Shafter to Presidio to Ruidosa to Candelaria and again that we might make the next day. We had a scrumptious meal and fellowship collectively. We realized that neither Andy nor her husband had ever been to the Large Bend. Andy, as a fourth-year medical scholar, had by no means finished a rural rotation though she had volunteered for the same well being truthful in Ft. Stockton not too long ago. She was excited to have the chance to drive to one of the remoted frontier communities in Texas, Candelaria (inhabitants about 75 inhabitants). Candelaria sits on the banks of the Rio Grande (Rio Bravo as it’s identified in Mexico) river. Candelaria has no entry to native well being care or any commerce in Candelaria. Residents of Candelaria can cross the river over a wire bridge to entry a doctor in Mexico within the neighboring Mexican village of San Antonio Del Bravo. The closest US well being care is a 120-mile spherical journey away on the FQHC clinic in Presidio from 8 AM to five PM Monday by Friday solely. The closest emergency room and labor and supply unit is that very same 300-mile spherical journey to the realm’s solely essential entry hospital in Alpine.

A number of occasions previously decade, the FQHC has partnered with the TDSHS Workplace of Border Public Well being to placed on a well being truthful in Candelaria. One of many Affiliate Commissioners of Well being from the TDSHS joined us and we had been in a position to study of the state’s public well being efforts in far to succeed in locations like Candelaria in addition to to plan how the FQHC and TTUHSC might work with the state to serve populations akin to Candelaria. We had been in a position to supply blood strain and glucose screenings and well being training primarily in Spanish to the roughly 50 neighborhood members. A TDSHS dentist and his workforce did cursory pediatric dental exams and utilized fluoride on their enamel. We helped hand out Christmas items to the youngsters of Candelaria. And, we took photos with Santa “Poncho” Claus and the Grinch. We ended the day by strolling to the wire bridge on the river.

On our return journey to Alpine, we stopped on the Presidio FQHC to drop off a medical assistant from the clinic who had accompanied us. We had a go to with a TTUHSC El Paso neurologist and ophthalmologist and their workforce who had been working to arrange telehealth tools on the clinic as a part of a US Division of Agriculture grant.

It was rewarding to me to have illustration by two TTUHSC campuses within the Large Bend that day making an attempt to enhance well being disparities and entry to care points in a rural medically underserved space of Texas. I additionally remembered a quote from Dr. Paul Farmer, “Our most vital skilled accomplishments in life will probably be finished in partnership, as a workforce.” My hope for Andy and all different well being care professionals in coaching is that they’ve a possibility to expertise rural well being care as a part of their coaching. I hope that Andy and different college students will select rural well being care as their future careers. I’m proud that TTUHSC prioritizes rural well being care and makes alternatives akin to a visit to Candelaria or Presidio out there to college students.

— Adrian Billings MD, PhD, FAAFP

Affiliate Educational Dean of Rural and Group Engagement, TTUHSC PB

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